Category Archives: CNS drugs

Pharmacotherapy of OCD: Interview

First-line treatments of OCD often fail. This means that for some patients, a single SSRI at optimal doses is not enough to achieve remission.

In this new Psychopharmacology Institute podcast, Dr. Guzman interviews expert psychiatrist Dr. David Veale on treatment resistant-OCD. It’s interesting to learn about the role of clomipramine in the treatment algorithm.


  • Practical definition of treatment-resistant OCD
  • Stepped-approach to pharmacotherapy
  • Efficacy of second-generation antipsychotics as augmentation strategy
    • When to use them
  • Other treatment options

Pharmacotherapy of treatment-resistant OCD

Citalopram and Escitalopram compared

There are significant differences between these two SSRIs. The FDA warned about the risk of QT prolongation with high doses of citalopram, but not escitalopram. Dosing is different too. To learn more about these similarities and differences check the following video published at the Psychopharmacology Institute website: Citalopram and Escitalopram: A Summary of Key Differences and Similarities

Benzodiazepines mechanism of action

Benzodiazepines and GABA receptors: an animation on their mechanism of action Gamma amino butyric acid (GABA) is an inhibiting neurotransmitter that is present on human brains. As shown in the animation, gamma amino butyric acid promotes opening of a postsynaptic receptor, the GABA-A receptor. This opening leads to a increased conductance to cloride ions, which…

Video: Side effects of SSRIs

The following video is a short overview on the pharmacological basis of SSRIs side effects. Outline: Facts about SSRIs adverse effects. Gastrointestinal adverse effects. 5-HT3 and 5-HT4 receptors in the GI tract. 5-HT3 receptors in the brainstem and hypothalamus. CNS adverse effects. 5-HT2A receptor stimulation at the basal ganglia. 5-HT2A and 2C receptors are hypothetically…

Aripiprazole (Abilify) not approved for bipolar disorder

According to a press release, the Scottish Medicines Consortium (SMC) did not accept aripiprazole for the treatment of manic episodes in bipolar I disorder and for the prevention of  new manic episodes. According to the SMC, the manufacturer did not present a sufficiently robust economic analysis to gain acceptance. Psychiatrist Daniel Carlat from “The Carlat…

Agomelatine (Valdoxan) for major depressive episodes

Agomelatine (Valdoxan, Melitor, Thymanax) is a recently marketed new drug for the treatment of major depression with a novel mechanism of action. It can be included in the class of  “other antidepressants”, or classified as a melatonergic drug. Mechanism of action Agomelatine acts as an agonist on melatonin MT1 and MT2 receptors. Additionally, it blocks…

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